Double V-Y Flaps for Post Burn Contracted Neck

Abstract

Background: Several techniques have been defined to beused in surgical treatment of post burn contracted neck. But,there were many problems with those techniques, like failureof graft take and postoperative contracture of the graft. Thecommonest problem in those techniques was distal flap necrosiswhich is frequently seen. As most of these techniques werebased on random-pattern flaps and there is usually a poorblood supply to the scar tissue. But, here in this study, we canbenefit from expansion in the distal part of the upper chestand lower neck caused by continuous traction of the contractedband which leads to expansion of the surrounding tissue withexcess skin.Aim of the Study: In this study, we aim to shift the excesstissue resulted from tissue expansion caused by traction ofthe contracture band from the base of the neck and upperchest to the upper neck by “double V-Y flaps” with directclosure of the donor site.Patients and Methods: 17 patients with post burn scarringof the neck were included in this study. 11 females and 6males with average age 20 (9-32) years old. 9 patients withdouble linear contracture and 8 patients with band contracture.Release of post burn scarring of the neck by “double V-Yflaps” was done, the excess tissue of the flap was used anddirect closure of the donor site was done.Results: The postoperative results represent the successof this technique in the surgical treatment of post burn scarcontractures of the neck. All patients had an uneventfulpostoperative period with no distal flap necrosis. There waspostoperative wound disruption in one patient that was managedby secondary sutures. The post burn scarring was successfullymanaged with this surgical technique “double V-Yflaps”, with no major postoperative complications. One yearfollow-up period revealed no recurrence of the contractedbands.Conclusion: “Double V-Y flaps” is a good technique insurgical treatment of post burn contracted neck with doublelinear or band contracture lines. This technique offers thepatient a good chance for release of post burn contracted neckwith no need to use graft or to wear postoperative neck collar.